MENOPAUSE AND PELVIC FLOOR

MENOPAUSE
July 18, 2017
PHYSIOTHERAPY FOR CONSTIPATION
July 18, 2017

MENOPAUSE AND PELVIC FLOOR

So i attended the course and its been a few weeks since.  It takes a while to see how a course will inform practice.  I have used what i learnt to empathise greatly with clients who really are having to   “cope” with Menopause symptoms.  The fact is that Menopause will start to occur for most women, anywhere from 45 to 55 years old.  Some women will go into “early” Menopause before the magic 45 year start.  Many will notice signs somewhere within the usual 45 to 55 year time frame.  So lets face it, there’s a  big difference between 45 and 55 years old.  I notice that women who are experiencing symptoms before 50 seem to feel that they are a bit young, and those after 50 are accepting or wondering when on earth Menopause will happen because they really are fed up with periods! As for those who have menopause before 45, well it really is young and i would recommend that all women consult a great G.P with an interest in the subject to ensure that you are able to make an informed choice regarding hormone replacement therapy or not.  Those with early menopause are at risk of certain health issues such as osteoporosis.  If you don’t chose hormone replacement therapy then you will need to make informed decisions regarding exercise to prevent osteoporosis and diet options to optimise bone calcification.  Typically menopause symptoms in those who experience them (not all women do) may be hot flushes i.e. a powerful feeling of  heat in the body that literally makes you want to fling the windows open or turn on the air conditioner or take off a layer of clothes.  Women may have increased anxiety, notice soft tissue laxity generally in the body and the pelvic floor: yes everything seems to be going south!  Typically women may notice vaginal dryness- yes usual secretions are no longer present.  During intercourse the vagina may feel different..less lubrication perhaps or perhaps less comfortable.  Not all women have these issues.  If you read generally about menopause, you will read that women may experience decreased libido.  But is it really decreased libido or is it that life is stressful for other reasons and libido is decreased with stress?  Is it that libido is fine but that the pleasurable sensations of sex have changed so sex doesn’t feel as good as it used to?  In the end, why would we want to do something that doesn’t feel good?  My course made me think about the role of Thyroid.  Changes in Thyroid function can mimic some of the typical symptoms of menopause.

The course i attended was really all about education for me.  If i am on top of the subject then i can at least inform clients correctly.  I see a lot of clients who present with bladder symptoms around the time of Menopause.  This is because women are experiencing a decline in their oestrogen and progesterone levels.  These 2 hormones work in harmony throughout the reproductive years, ebbing and flowing through the monthly cycle.  Oestrogen is dominant in the first half of the cycle and progesterone dominant in the second half.  Progesterone is the hormone that prepares the lining of the uterus for pregnancy.  If a pregnancy does not occur then menstruation occurs as the lining of the uterus is shed and bleeding occurs. Oestrogen is an amazing hormone that works throughout the body and in ways that it seems medical science still doesn’t understand fully. Progesterone is probably the lesser thought of hormone but works in fascinating ways along side oestrogen.  Imbalances in one or the other may lead to dominance and the phenomenon of “oestrogen dominance” has had a lot of press.  Ie women are not benefiting from the balancing effect of progesterone and may have subtle but persistent malaise as a result.

I will finish by encouraging all women who are worried about their well being or hormone status to seek help from a g.p or specialist (endocrinologist) who is genuinely interested in the subject.  Yes Menopause is a “normal” part of life, but then so is aging !! Do we dismiss those with high blood pressure as “just a part of ageing and gaining weight and just normal, deal with it”  NO.  We get help and we educate ourselves and navigate a pathway through.

I would like to be more specific about details regarding menopause and hormone effects on the body.  Perhaps that post will follow!!